DCIS Recurrence Rate Low in Young Women
Study: Young and Old Patients Do Equally Well With Early Form of Breast Cancer
DCIS in Young Women continued...
Following initial surgery, tumors were examined for evidence of cancer around the sides, or margins, of the removed tissue. If cancer cells were seen by pathologists, surgeons would take more tissue until tumor margins were free of cancer.
Three out of four (75%) of the patients who were aged 40 or younger had this additional surgery, known as surgical re-excision, compared to 62% of all patients.
All the women also received five weeks of whole-breast radiation, and 95% also received the radiation boost at the site of the removed tumor.
The average follow up was 6.8 years (range 0.2 to 24 years) and the average age of the patients at treatment was 56.
Overall, the local recurrence rate was 7% at 10 years and 8% at 15 years.
DCIS recurrence rates did not vary by age, tumor margin status after lumpectomy, or whether or not the patients took tamoxifen.
Turaka credits the low recurrence rate to careful patient selection, the use of surgical re-excision, and the radiation boost.
Expert: More Study Needed
Radiation oncologist Jennifer F. De Los Santos, MD, says careful surgical follow up and the radiation boost may negate the increased risk associated with young age in patients with DCIS.
But she adds that the number of young DCIS patients in the study was far too small to conclude that young patients have the same prognosis with aggressive treatment as older women.
“This was not a randomized study and there were only 24 patients who were 40 years old and younger,” she tells WebMD. “While the findings are provocative they are in no way conclusive because of these two things.”
De Los Santos says a larger, randomized study is under way that should help clarify the role of boost radiotherapy in the treatment of DCIS patients.
Debbie Saslow, PhD, of the American Cancer Society, says studies like this show the importance of treating DCIS aggressively.
“Some people say that we are over-treating DCIS, and it is true that some women may be getting more aggressive treatment than they really need,” she tells WebMD. “We’ve been saying all along that you have to treat DCIS, because if you don’t do anything a lot of women will end up with invasive cancer.”